NPIMap

Individual provider Active NPI

Laurie Ann Beach

  • Family Nurse Practitioner
  • Pilot Grove, MO
National Provider Identifier
1811993264
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
110297 Issued in MO
Practice address
212 College St
Pilot Grove, MO 65276-1005
Phone
(660) 831-3728
Fax
(660) 831-3326
NPI assigned
Jun 21, 2005
Last updated
Feb 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 110297 MO Primary

Addresses

Primary practice location

212 College St
Pilot Grove, MO 65276-1005

Mailing address

PO Box 271430
Fort Collins, CO 80527-1430
Phone (970) 488-1640

Other identifiers 2

IdentifierTypeStateIssuer
000082595OtherMOMEDICARE NUMBER
001014600OtherMOMEDICARE PART B

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lauriebeach@fitzgibbon.cernerdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050819000181 MO Practitioner - Nurse Practitioner 1456302033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Columbia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

212 College St
Pilot Grove, MO 65276-1005
Phone (660) 834-5100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John Fitzgibbon Memorial Hospital Inc Clinic/Center CurrentSince Jan 1, 2022 Accepting new patients
John Fitzgibbon Memorial Hospital Inc Clinic/Center Current Accepting new patients
John Fitzgibbon Memorial Hospital Inc. CurrentSince Jan 1, 2022 Accepting new patients
Pilot Grove Rural Health Clinic PastSince Jan 1, 1990 Accepting new patients
Laurie a Beach PastSince Jan 1, 1990 Accepting new patients
Laurie a Beach Rural Health PastSince Jan 1, 1990 Accepting new patients
Specialized Wound Management LLC Clinic/Center Past Accepting new patients

Locations

815 E Broadway St
Brunswick, MO 65236
Phone (660) 548-3161

600 W Morrison St
Fayette, MO 65248
Phone (660) 248-2900

2305 S Highway 65
Bldg A
Marshall, MO 65340
Phone (660) 886-7800

212 College St
Pilot Grove, MO 65276
Phone (660) 831-3728

420 W Front St
Slater, MO 65349
Phone (660) 529-2251

Interoperability endpoints

  • Direct secure messaging: lauriebeach@fitzgibbon.cernerdirect.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Katy ManorPilot Grove, MO, CCN 265801 Skilled nursing facility Corporate Director
Managing Control - Governing Body		 May 1, 2016
May 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1811993264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 271430",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805271430",
            "telephone_number": "970-488-1640",
            "fax_number": "970-472-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 COLLEGE ST",
            "city": "PILOT GROVE",
            "state": "MO",
            "postal_code": "652761005",
            "telephone_number": "660-831-3728",
            "fax_number": "660-831-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACH",
        "first_name": "LAURIE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "110297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "000082595",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "001014600",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lauriebeach@fitzgibbon.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Laurie Beach Fitzgibbon Hospital DIRECT Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "212 College St",
            "city": "Pilot Grove",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652761005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pilot Grove, MO

Sources for this page

Verify at the official NPI Registry.